Provider Demographics
NPI:1659138600
Name:JOHNSON, ASHLEIGH CARMEN (LPN-IV)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:CARMEN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPN-IV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 E KELLOGG DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1607
Mailing Address - Country:US
Mailing Address - Phone:316-685-2221
Mailing Address - Fax:785-826-1660
Practice Address - Street 1:1410 E IRON AVE STE 1
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3285
Practice Address - Country:US
Practice Address - Phone:316-685-2221
Practice Address - Fax:785-826-1660
Is Sole Proprietor?:No
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS23-51114-024164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse